Department of Neurology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, 110-744, South Korea.
BMC Neurol. 2019 Aug 27;19(1):208. doi: 10.1186/s12883-019-1440-1.
Peripheral-type facial palsy very rarely arises from pontine stroke. We attempted to identify unique clinico-radiologic patterns associated with this condition.
Patients with pontine tegmentum stroke and acute onset of peripheral-type facial weakness were reviewed from the acute stroke registry of a tertiary hospital. The clinico-radiologic patterns of 10 patients were classified into one of three types based on the respective stroke mechanism. Type A (n = 5) was characterized by relatively diverse clinical presentations and larger, multiple infarctions resulting from large-artery atherosclerosis. Three cases with small lacunar infarcts were classified to type B (small vessel occlusion), and they showed only limited symptoms including horizontal gaze disturbance and facial paralysis. The two hemorrhagic cases (type C) presented with a focal pontine hemorrhage, likely due to a cavernous hemangioma.
Peripheral-type facial palsy often occurs in pontine stroke with specific patterns. Type recognition helps to determine the underlying mechanism and the appropriate clinical approach. In particular, focal pontine tegmental infarctions showing stereotypic combinations of ophthalmoplegia and peripheral-type facial weakness (type B) might be recognized as a new type of lacunar syndrome.
周围性面瘫很少由脑桥卒中引起。我们试图确定与这种情况相关的独特临床-影像学模式。
从一家三级医院的急性卒中登记处回顾了患有脑桥被盖部卒中且急性发作周围性面瘫的患者。根据各自的卒中机制，10 名患者的临床-影像学模式分为三种类型之一。A型（n=5）的特点是临床表现相对多样化，且由于大动脉粥样硬化导致多发性较大梗死。3 例小腔隙性梗死病例被归类为 B 型（小血管闭塞），它们仅表现出有限的症状，包括水平凝视障碍和面瘫。2 例出血性病例（C 型）表现为局灶性脑桥出血，可能由于海绵状血管瘤所致。
周围性面瘫常发生于具有特定模式的脑桥卒中。类型识别有助于确定潜在机制和适当的临床方法。特别是表现出固定组合的眼肌麻痹和周围性面瘫（B 型）的局灶性脑桥被盖部梗死可能被认为是一种新的腔隙综合征类型。
